Provider Enrollment Specialist

Provider Enrollment Specialist

We are seeking a credentialing candidate that is a highly motivated, autonomous individual who has a positive attitude to join our company as a Provider Enrollment Specialist on the Managed Care Operations team.

The enrollment specialist ensures that all data entry is accurate, including demographic and financial information for each account. Responsible for researching complex problems using available resources and implementing solutions to mitigate any future issues. This job will be responsible for working various work queues and other duties as assigned. The responsibilities will be aligned with the timely and accurate entry of all phases of enrollment/billing process for exceptional level of service to our members. This job requires professional behavior, dependability and good communication skills.

Qualified candidates must possess:

• Minimum of 3-5 years' experience submitting payor credentialing applications for providers
• Health plan knowledge and familiarity required credentialing all payor types: Managed Care, Medicare & Medicaid Replacements & Workers Compensation
• Experience utilizing & maintaining credentialing database
• Highly knowledgeable & proficient with CAQH database. Familiarity with CAQH Practice Administrator role.
• Have established relationships with credentialing reps at various health plans
• Prepare and process credentialing applications for all payor types
• Experience credentialing multi-Tax ID entities
• Comfortable processing high volume credentialing applications & recredentialing applications
• Meet and adhere to company's turnaround time and comply with credentialing goals and performance metrics
• Customer service oriented & easily able to develop relationships.
• Will have a detail-oriented and motivated work ethic, as well as capable of managing projects in a timely manner to meet set deadlines
• Possess excellent organizational, interpersonal, and communication skills

MS Word, Excel & Access skills required

Work Environment

• The role follows a remote work schedule central hours.
• Must be able to work in a fast-paced environment and manage multiple tasks with minimal supervision.

What You'll Get:

• Comprehensive great inexpensive benefits.
• Generous paid time off with holidays.
• Continuous mentoring to further your career path.
• Great close-knit team environment. We work hard, but we have fun!